A 43-year-old female presented with persistent headache and dizziness which had first occurred two years earlier. The physical and neurological findings at admission were unremarkable, though plain radiography revealed the presence of a dense calcified mass in the left frontal area, and CT showed that a homogeneous high-density nodule was attached to the inner surface of the left frontal skull. The hard bony mass found and excised during surgery was shown at histopathologic examination to be a subdural osteoma. We describe the clinicopathologic findings of this entity and discuss the radiological features which suggest its subdural location.
Adult ; Case Report ; Female ; Frontal Bone/*pathology/*radiography/surgery ; Human ; Osteoma/*pathology/*radiography/surgery ; Skull Neoplasms/*pathology/*radiography/surgery ; Subdural Space/pathology/radiography/surgery ; Tomography, X-Ray Computed

An epithelioid hemangioma involving three contiguous bones in continuity has, to the best of our knowledge, not been reported in the literature. A case of a 48-year-old man presented with radiating pain to the lower thoracic region for two years. A radiograph and CT scan revealed both permeative osteolytic and multiple trabeculated lesions involving the left posterior part of the 10th rib as well as the 9th and 10th vertebral bodies in continuity and was misled as a malignant or infectious lesion. The histopathology and immuno-histochemistry of the lesion confirmed the diagnosis of an epithelioid hemangioma. The lesion was still stable as of three years after surgery.
Bone Neoplasms/pathology/*radiography/surgery ; Diagnosis, Differential ; Hemangioendothelioma, Epithelioid/pathology/*radiography/surgery ; Humans ; Male ; Middle Aged ; Ribs/pathology/*radiography/surgery ; Spinal Neoplasms/pathology/*radiography/surgery ; Thoracic Vertebrae/pathology/*radiography/surgery ; *Tomography, X-Ray Computed

Primary hemangiopericytoma of the rib is extremely rare and only a few cases have been reported. A 62-yr-old man presented with an aching chest pain and dyspnea. Thoracic computed tomography revealed a homogenous mass expanding the right seventh rib. A diagnosis of hemangiopericytoma was established by percutaneous needle biopsy. Preoperative embolization of the feeding vessels of the tumor was performed in order to prevent perioperative bleeding. There was no significant bleeding during the surgery, where complete resection of the tumor with 7th to 9th ribs with a surgical margin of 5 cm was performed. Postoperative course was uneventful and there has been no recurrence for thirteen months. To our knowledge, there has been no report to apply a preoperative embolization of a primary hemangiopericytoma of the rib.
Bone Neoplasms/pathology/radiography/*surgery ; *Embolization, Therapeutic ; Hemangiopericytoma/pathology/radiography/*surgery ; Humans ; Male ; Middle Aged ; *Ribs ; Tomography, X-Ray Computed

BACKGROUND: The relationship between surgical margin and local recurrence (LR) in osteosarcoma patients with poor responses to chemotherapy is unclear. Moreover, the incidences of LR according to three different resection planes (bone, soft tissue, and perineurovascular) are not commonly known. METHODS: We evaluated the incidence of LR in three areas. To assess whether there is a role of surgical margin on LR in patients resistant to preoperative chemotherapy, we designed a case (35 patients with LR) and control (70 patients without LR) study. Controls were matched for age, location, initial tumor volume, and tumor volume change during preoperative chemotherapy. RESULTS: LR occurred at the soft tissues in 18 cases (51.4%), at the perineurovascular tissues in 11 cases (31.4%), and at the bones in six cases (17.2%). The proportion of inadequate perineurovascular margin was higher in the case group than in the control group (p = 0.01). Within case-control group (105 patients), a correlation between each margin status and LR at corresponding area was found in the bone (p < 0.001) and perineurovascular area (p = 0.001). CONCLUSIONS: LR is most common in soft tissues. In patients showing similar unfavorable responses to chemotherapy, the losses of perineurovascular fat plane on preoperative magnetic resonance imaging may be a valuable finding in predicting LR.
Adolescent ; Bone Neoplasms/*pathology/radiography/*surgery ; Case-Control Studies ; Chi-Square Distribution ; Female ; Humans ; Male ; Neoplasm Recurrence, Local/*pathology ; Neoplasm, Residual/pathology ; Osteosarcoma/*pathology/radiography/*surgery

It has been reported that the common sites of brown tumors are the jaw, pelvis, ribs, femurs and clavicles. We report our experience in a case of brown tumor of the patella caused by primary hyperparathyroidism. An initial radiograph and CT showed an osteolytic lesion and MR images showed a mixed solid and multiloculated cystic tumor in the right patella. One month after the parathyroidectomy, rapid bone formation was observed on both radiographs and CT images.
Adult ; Bone Density ; Bone Neoplasms/*etiology/radiography/*surgery ; Female ; Humans ; Hyperparathyroidism, Primary/*complications/*surgery ; Parathyroidectomy ; Patella/*pathology/radiography ; Tomography, X-Ray Computed

Adult ; Bone Cysts, Aneurysmal ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Giant Cell Tumor of Bone ; pathology ; Humans ; Osteosarcoma ; pathology ; Radiography ; Spinal Diseases ; diagnostic imaging ; pathology ; surgery ; Spinal Neoplasms ; pathology ; Spine ; diagnostic imaging ; pathology ; surgery

Bone Neoplasms ; diagnostic imaging ; pathology ; secondary ; surgery ; Chondrosarcoma ; diagnostic imaging ; pathology ; secondary ; surgery ; Fingers ; Humans ; Male ; Middle Aged ; Osteochondroma ; pathology ; Radiography

Adult ; Aged ; Aged, 80 and over ; Bone Cements ; Bone Neoplasms ; diagnostic imaging ; surgery ; Diaphyses ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Limb Salvage ; methods ; Male ; Middle Aged ; Radiography ; Treatment Outcome

OBJECTIVETo explore the clinicopathologic features of Ollier's disease, its chondrosarcomatous transformation and related differential diagnoses.

METHODSA total of 19 cases of Ollier's disease and 8 control cases of pure multiple enchondroma were investigated by imaging studies including X-ray, CT or MRI, and hematoxylin and eosin stain.

RESULTSAmong 19 cases of Ollier's disease, 12 were men and 7 were women with a mean age of 20 years (range, 5-66 years). Ollier's disease involving short tubular bones of extremity were lytic defects with bony expansion, thinning or disappearance of the overlying cortex surrounded by periosteal fibrous tissues. When occurring in the long bones, the disease showed radiolucent columns of dysplastic cartilage that extended from the metaphysis to diaphyseal and created bowing deformation and limb asymmetry. Microscopically, the cartilage present in the small bones of the hands and feet tended to be more hypercellular with more abundant enlarged or binucleated nuclei. The lesion in long bones appeared multicentric, surrounding with a thin rim of bone and calcification. Six cases of Ollier's disease had developed secondary low-grade chondrosarcoma.

CONCLUSIONSLow-grade chondrosarcomatous transformation can occur in dysplastic cartilage of Ollier's disease. The diagnosis of such sarcomatous transformation should be determined by invasion, but not atypicality of the cartilagenous cells. There are certain differences between the secondary chondrosarcoma of Ollier's disease and conventional chondrosarcoma on clinical, radiographical and pathological grounds.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; diagnostic imaging ; etiology ; pathology ; surgery ; Cell Transformation, Neoplastic ; Child ; Chondrosarcoma ; diagnostic imaging ; etiology ; pathology ; surgery ; Diagnosis, Differential ; Enchondromatosis ; complications ; diagnostic imaging ; pathology ; surgery ; Exostoses, Multiple Hereditary ; pathology ; Female ; Humans ; Male ; Middle Aged ; Radiography ; Young Adult

OBJECTIVETo study the clinical manifestations, radiologic findings, pathologic diagnosis and differential diagnosis of primary osteosarcoma in elderly patients.

METHODSTwelve cases of primary osteosarcoma occurring in patients older than 60 years were encountered during the period from 1985 to 2010. The clinical manifestations, radiologic features and pathologic findings were studied and the follow-up data were analyzed.

RESULTSThe sites of involvement included long bones (number = 7), ilium (number = 1), craniofacial bones (number = 2) and soft tissue (number = 2). Radiologic examination showed a mixture of osteosclerotic and osteolytic lesions in 10 patients, soft tissue lesions with high-density areas in 2 patients and soft tissue lesions with periosteal reaction in 8 patients. Histologically, most cases showed features of conventional osteosarcoma. There were 2 cases of malignant fibrous histiocytoma-like osteosarcoma, 2 cases of chondroblastic osteosarcoma and 1 case of well-differentiated intraosseous osteosarcoma. Immunohistochemical study played little role in pathologic diagnosis. Ten patients had undergone amputation, including one patient who had received adjuvant chemotherapy beforehand. Nine patients had follow-up information available. Three of them died of lung metastasis and 1 died of cardiovascular disease.

CONCLUSIONSPrimary osteosarcoma rarely occurs in elderly patients and can easily be missed. Correlation with clinical, radiologic and histologic features is important for arriving at a correct diagnosis.

12E7 Antigen ; Aged ; Antigens, CD ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma ; pathology ; Diagnosis, Differential ; Female ; Femoral Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Ilium ; Lung Neoplasms ; secondary ; Lymphoma ; pathology ; Male ; Middle Aged ; Osteitis Deformans ; pathology ; Osteosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Radiography ; Soft Tissue Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism